Childhood Disorders

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Bipolar Disorder in Childhood and Early AdolescenceReview - Bipolar Disorder in Childhood and Early Adolescence
by Barbara Geller and Melissa P. DelBello (Editors)
Guilford Press, 2003
Review by Valérie Aucouturier
Feb 26th 2008 (Volume 12, Issue 9)

This collection of fifteen scientific papers presents the results psychiatrists, psychologists, neurologists and geneticists have found in their recent enquiries on the diagnosis, the biological manifestations and the possible treatments of this mental illness in childhood and early adolescence. Consequently, this book is a genuinely scientific work, not suited for casual readers merely looking for general information on the topic. However, it is certainly an important source of information for clinicians and practitioners.

Bipolar disorders are a category of mood disorders characterised by unusual shifts in a person’s mood, energy, and ability to function, which are different from the ordinary ups and downs that everyone goes through. The most common form of bipolar disorder is known as manic-depressive illness, in which the person experiences cycles of manic episodes of abnormally elevated mood and depressive episodes or symptoms. Some of the organic neural causes of bipolar disorder are well-known and hence it can be relatively well treated.

Actually, bipolar disorder has long been considered as an exclusively adult disorder of which the symptoms usually appear between age twenty and forty. Now, this work not only stresses the relevance of addressing the issue of child and adolescent bipolar disorder, it also offers a very interesting overview of some of the recent research led in this field. Lately, by the way, the latter was largely put aside in comparison with other kinds of mental disorders (such as hyperactivity, obsessive-compulsive disorders, etc.).

This book is concerned with three main topics: the diagnosis and apparition of childhood and early adolescence bipolar disorder, its neurobiological manifestations and heredity factors, and the ways to treat and cope with such a mental disorder.

The first section of the book is composed of five articles which focus on the symptoms of bipolar disorders in childhood and adolescence. The first paper (P.M. Lewinsohn, J.R. Seeley, D.N. Klein) presents the results of a study (the Oregon Adolescent Depression Project) conducted by researchers in psychology on the important correlation between some adolescents' suicidal behaviours and the onset of bipolar disorder symptoms. The second article (B.Geller, J.L. Craney, K. Bolhofner, M.P. DelBello, D. Axelson, J. Luby, M. Williams, B. Zimerman, M.J. Nickelsburg, J. Frazier, L. Beringer) relates a very elaborate phenomenological enquiry led on subjects aged between seven and sixteen. This enquiry studies the pathological manifestations of maniac and hypomaniac symptoms in this population. The third paper (S. Dejong, J.A. Frazier) highlights the likelihood of a relationship between Pervasive Developmental Disorders (PDD are early childhood mental pathologies involving social, communicative and behavioural disorders, the most well-known among these disorders is probably autism) and bipolar disorder; the latter is generally ignored because its symptoms are often mistaken for symptoms of the PDD. This article ends with three interesting case studies illustrating the hypothesis that has been examined. The following paper (F. Papolos) investigates, more broadly, the questions concerning the classification (nosology) of mental disorders and the the problems one encounters in the diagnosis of bipolar disorders (in childhood and adolescence) because of their commonly being coupled with other disorders (comorbidities). The last paper of this section (K. Chang, H. Steiner) suggests that, given the observed heredity of bipolar disorder and the scientific knowledge of its neurological symptoms, offspring studies (i.e. studies of children and adolescents born from one or both parents with bipolar disorder) need to be promoted and improved in order to prevent or minimise the development of the disease.

The next section presents several neuroscientific accounts of bipolar disorders together with immunologists' and geneticists’ approaches toward them. These articles give us clues as to which different techniques or approaches toward the brain are relevant to the study of mental disorders. The respective focus lies on neurobiological factors (such as the hypofunction of the NMDA receptor (a glutamate receptor); see paper six by N.B. Faber, J.W. Newcomer), observations by neuroimaging to locate the possibly damaged brain regions (M.P. DelBello, R.A. Kowatch), and neuroscience studies on emotional processes in order to examine the biological underpinnings of moods and emotions related to bipolar disorder (R.K. Bhangoo, C.M. Deveney, E. Leibenluft). The section continues with a study on the correlation between illnesses due to immune dysfunction and symptoms of bipolar affective disorder and its relevance for children affected by this disorder (O. Soto, T.K. Murphy); this is further associated with the consideration of the changes in biological rhythm (especially sleep), which analyses the adequacy of using mood stabilisers in treating children (U. Rao). The last paper of this section (J.A. Badner) focuses on the genetics and the heredity of bipolar disorder.

The book is concluded by a third section presenting four rather approachable papers, which, in contrast to the very technical ones, are more likely to interest people dealing with bipolar disorder on a daily basis. They analyse different types of treatment for bipolar disorder, namely pharmacological (N.D. Ryan), by psychotherapy (J.S. Goldberg-Arnold, M.A. Fristad), with the last two papers giving respective advice on family interventions (M.A.Fristad, J.S. Goldberg-Arnold) and internet support (M. Hellander, D.P. Sisson, M.A. Fristad).

Although I am not knowledgeable enough to judge the scientific content of these papers, I can still assert that this very dense collection of many diverse researches on this emerging field of study raises a lot of interesting points and most certainly opens the way for further studies.

© 2008 Valérie Aucouturier

Valérie Aucouturier is a research student at the Université Paris 1 (France) and the University of Kent (UK).

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